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Treatment results of laparoscopic surgery in Japanese patients with upside-down stomach

机译：日本胃倒立患者的腹腔镜手术治疗结果

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Introduction Upside-down stomach, an atypical form of esophageal hiatal hernia, is a rare pathology. Due to its anomalous anatomical characteristics, the level of difficulty of laparoscopic surgery is considered to be high. However, as the number of patients is very small in Japan, surgical results have not been fully investigated. We examined the results of surgical treatment for Japanese patients with upside-down stomach. Materials and methods The subjects were 11 patients given a diagnosis of upside-down stomach based on upper gastrointestinal tract radiographic imaging and who had undergone laparoscopic surgery at least 6 months prior to this study. Surgical results, postoperative recurrence, and postoperative oral intake of gastric acid-suppressive medications were examined. Results The subjects consisted of one man and ten women (91 %). The mean age was 73.0 +- 9.2 years and the mean disease period was 38.7 months. The operation time was 175.5 +- 49.1 min (range 110-280) and the intraoperative blood loss was 122.7 +- 214.9 mL (range 0-550). None of the patients had required conversion to laparotomy. The mean postoperative hospital stay was 8.9 +- 3.4 days (range 7-18) and two patients had persistent dysphagia after surgery, which improved with endo-scopic dilatation. While two patients (18 %) had a postoperative recurrence of hiatal hernia, none required reoperation. Two patients (18 %) needed oral gastric acid-suppressive medications postoperatively. Conclusions Laparoscopic surgery could be performed in all patients with upside-down stomach. Because of the significant recurrence rate of postoperative esophageal hiatal hernia, the use of a mesh may be required.
机译：引言倒置胃是食管裂孔疝的一种非典型形式，是一种罕见的病理。由于其异常的解剖学特征，认为腹腔镜手术的难度很高。但是，由于日本的患者人数很少，因此尚未对手术结果进行充分的调查。我们检查了日本胃部倒置患者的手术治疗结果。材料和方法该受试者为11名根据上胃肠道X线影像学诊断为胃倒置的患者，并且在该研究之前至少6个月接受了腹腔镜手术。检查手术结果，术后复发和术后口服胃酸抑制药物。结果受试者包括一男十女（91％）。平均年龄为73.0±9.2岁，平均疾病期为38.7个月。手术时间为175.5±49.1分钟（范围110-280），术中失血量为122.7±214.9 mL（范围0-550）。没有患者需要转换为剖腹手术。术后平均住院天数为8.9±3.4天（范围7-18），两名患者术后持续吞咽困难，内镜下扩张可改善这种情况。两名患者（18％）术后发生了食管裂孔疝复发，但无一例需要再次手术。两名患者（18％）术后需要口服胃酸抑制药物。结论所有胃部倒置的患者均可进行腹腔镜手术。由于术后食管裂孔性疝的复发率较高，可能需要使用网片。

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